Category Archives: Injury Prevention

After rescue, Children’s nurse encourages water safety education

Leah Mickschl

At Children’s Hospitals and Clinics of Minnesota, we encounter life-and-death situations every day.

Earlier this summer, Leah Mickschl, a Children’s RN, experienced a crisis outside our walls. She was at a private neighborhood pool in Lakeville when a 4-year-old boy was discovered at the bottom of the pool.

She was in the right place at the right time.

Mickschl, who works at Midwest Children’s Resource Center, called upon her training and performed CPR on the boy. He had been under water for approximately two minutes, she said. But within seconds of having CPR performed on him, he sputtered water and regained consciousness. The boy recovered, and today, he’s active and healthy.

In July, the Lakeville City Council honored Mickschl for her life-saving efforts. She appreciates the honor and wants to use it as an opportunity to remind people of aquatic safety.

On the day of the boy’s near-drowning, the pool was filled with people – children and adults, she said. No one saw him go under; Mickschl’s own children were only a few feet away.

Leah Mickschl with her family

“Drowning is silent. It’s not like in the movies where you’re thrashing about and calling for help,” Mickschl said.

Unfortunately, drowning is the leading cause of accidental death among children ages 1 to 4, according to the Centers for Disease Control and Prevention. It remains the second leading cause of unintentional injury-related death behind motor vehicle crashes among children 1 to 14.

Mickschl encourages people to check out these water-safety tips from Children’s Dr. Manu Madhok before they head to the pool or lake. She also suggests getting CPR-certified.

“Prevention should always be the goal, but you never know when those skills might be needed,” she said.

Using technology to keep kids safe

This is a post by Dr. Rod Tarrago, a pediatric intensive care physician at Children’s Hospitals and Clinics of Minnesota.  He is also the Chief Medical Information Officer and is proud to admit he’s a computer geek.  He’s been helping improve the care at Children’s through the use of technology and spends most of his time helping other clinicians improve their understanding of the computer system. He’s the proud father of two young boys and future computer geeks. 

Dr. Rod Tarrago

We’ve been using computers to help take care of kids at Children’s for several years. We order medicines, track kids’ vital signs, and look at X-rays on computers. Now, we’re starting to use more advanced technology to make sure we keep kids as safe as possible. Many of the children we treat have complex cases and require various medicines. That can be very confusing and potentially dangerous for those taking care of the patient. Can you imagine trying to keep perfect track of a patient who has more than 30 medicines, especially when doses and times are changing?

Recently, we’ve started using familiar technology – medication scanners – in our Minneapolis Pediatric Intensive Care Unit (PICU). The scanners are similar to those used in other industries where a scanner checks a bar code to make sure it’s the right product. In our case, patients and families may have seen our nurses and respiratory therapists “scanning” the kids’ medicines prior to giving them.  Just as we previously were checking our patients’ ID bands to make sure the right medicine was being given to the right child, we’re now using the computers to make sure that it’s the right medicine at the right time with the right dose via the right route to the right patient. Children’s is the first pediatric hospital in the nation to use this technology.

Our nurses, respiratory therapists and information technology departments worked hard to make sure that the rooms were set up correctly and that the scanners worked for all medicines. They even changed the labels to make sure wrinkles were less likely to interfere with the scanning. They also came up with some creative solutions to lower the volume so that the beeping of the scanners wouldn’t wake up the kids at night.

In the busy Minneapolis PICU, nurses scan more than 2000 medications every week, and this has helped us detect several instances in which medications might have been given early or late.

At Children’s our No. 1 priority is to keep our patients safe and help them get better.  By using our new scanner technology to more safely deliver medicine to the kids, we are staying at the forefront of medicine. Over the next few months, we’ll extend this important technology to other units at Children’s.


Fireworks safety: Avoid the ER on the Fourth of July

This is a post by Dr. Robert Sicoli, co-medical director of our emergency department. Dr. Sicoli is a fellowship trained Pediatric Emergency Medicine physician with over 20 years of experience. This post originally appeared on GoodyBlog

(Credit: iStock photo by rozbyshaka)

While lighting off a few bottle rockets or running around the backyard with a lit sparkler may seem like relatively harmless ways for kids to celebrate our nation’s independence, thousands of people each year are injured by fireworks, many of them landing in an emergency room.

According to the Consumer Product Safety Commission, there were more than 8,600 injuries involving fireworks in 2010. Forty percent of those injuries involved children younger than 15. While the safest bet is taking your family to a public fireworks display, many states allow the use of various types of fireworks for private use. If you live in a state that allows fireworks for private use, following these safety tips while using fireworks will help keep you and your family safe this Fourth of July.


Before use:

  • Make sure the fireworks you buy are ready to use. Avoid kits that require assembly or crafting your own at home.
  • Don’t buy fireworks with brown labels or wrapped in brown paper. Those are usually made for public displays and not intended to be used privately.
  • Always follow the directions on the label carefully.
  • Always light fireworks outside and away from combustibles, like dry leaves and grass.
  • Choose the proper area for the fireworks you’re using (i.e. don’t use bottles rockets in a wooded area or near a busy street).

During use:

  • Don’t let kids under 10 use any type of fireworks, even sparklers. Sparklers burn at a temperature of up to 1800 degrees Fahrenheit, which is hot enough to melt some metals.
  • Light fireworks one at a time, never lash multiple fireworks together, never point them toward another person and make sure to wear eye protection.
  • Keep a hose or bucket of water nearby.

After use:

  • Never try to re-light a “dud.” Wait at least ten minutes and then douse it with water.
  • Soak all fireworks in water before throwing them away.
  •  Store extra or unused fireworks in a cool dry place.

While following these tips will help, sometime injuries happen. The most common areas of the body that are injured tend to be the hands, fingers, eyes, head and face, mostly with burns. If your child gets inured, considering the following:

  • If your child is burned by a firework and the burn is relatively mild (red or irritated skin), rinse it with cool water and apply an antibiotic ointment to the affected area.
  • If the burn is more severe (blistering, peeling and/or very painful) call your doctor or seek medical attention immediately.
  • If smoke or other particles get into the eyes, make sure your child doesn’t rub them; it will only make the irritation worse. Try cleaning their eyes out with cool water, but if your child complains of continued visual problems or is still in pain after flushing their eyes with water, seek medical attention.
  • Smoke inhalation is also another factor to consider when using fireworks. If your child has inhaled smoke, remove them from the smoky area and let them rest in a cool, ventilated area. If they continue to cough, their coughing is severe or they have difficult or labored breathing, consider calling 911 or bringing them to the emergency department.

The Fourth of July is a great time for families to have fun together. Here’s to a safe and happy Fourth!

For additional injury prevention tips, please visit our Making Safe Simple website.

Water safety tips from Dr. Madhok

This is a post by Dr. Manu Madhok, director of the pediatric emergency medicine fellowship program at Children’s Hospitals and Clinics of Minnesota. He’s a board member of the Minnesota chapter of the American Academy of Pediatrics.

Every summer, we read and hear about children who die due to accidental drowning. Sadly, this summer has been no exception in Minnesota.

Drowning is the leading cause of accidental death among children ages 1 to 4. According to the Centers for Disease Control, most drownings among children ages 1 to 4 occur in the pool at home. Drowning remains the second leading cause of unintentional injury-related death behind motor vehicle crashes among children 1 to 14.

While drowning is a tragedy, it’s one that can be prevented. I’ve compiled a list of tips I commonly share with parents and caregivers to make sure their kids are safe in and near the water.

Children ages 1-5

A common misconception is that kids only drown in deep water. A child can actually drown in only a few inches of water.

  1. Always keep children within arm’s reach.
  2. Inflatable aids are not substitutes for adult supervision.
  3. Enforce pool safety rules. That means no running or pushing.

Children ages 5-12

  1. Don’t allow horseplay.
  2. Make sure your child never swims alone and is always within view of an adult.
  3. Children should receive swimming lessons from a qualified instructor.

Open water

  1. Never allow a child to dive in without first checking the depth.
  2. Choose a swimming area that is under a lifeguard’s supervision.
  3. A child should always wear a life jacket while riding in a boat.

Backyard pool

  1. The pool needs to have a 4-foot tall fence surrounding it on all sides.
  2. Use a rigid cover for the pool.
  3. Install complaint, anti-entrapment drain covers.
  4. Pool owners should know CPR.

While kids are our thing at Children’s, we prefer to see them healthy and not to see them in the Emergency Department. Follow these tips so your child doesn’t become a statistic this summer. For more information about injury prevention, please visit our Making Safe Simple website.

For additional resources:

Minnesota Department of Health swimming pool links

Minnesota Department of Health injury data

Centers for Disease Control unintentional drowning data

Water Safety and Young Children

Water Safety for Older Children

Summer Safety Tips – Sun and Water Safety

Children’s takes steps to minimize radiation exposure

MRI Scanner

There’s often a lot of information in the media and medical journals about CT scans (known as Computed Tomography) and how they expose children to radiation. Most recently, The Lancet, a medical journal, published a study that reports that children who get multiple CT scans are at increased risk of leukemia and brain cancer.

We know children are more sensitive than adults to radiation exposure and that CT scans are one of the most common and significant medical exposures of children to radiation. We also know that although the risk of radiation from a CT scan is low, it’s not zero. There can be a slight increased risk of cancer later in life.

“We take this seriously, and we do everything we possibly can at Children’s to minimize the level of radiation exposure to our patients while preserving the quality of the images we need,” said William Mize, MD, a pediatric radiologist.

Here’s how:

  • Our scan settings are adjusted according to your child’s size and age.
  • We work under the ALARA (as low as reasonably achievable) principle. Some of the steps we take include limiting the area of exposure to include only the area of specific medical concern and shielding sensitive areas such as breast shielding during chest CT.
  • We don’t recommend a CT scan as a diagnostic test unless it’s necessary. When appropriate, we suggest other imaging tests such as an ultrasound or MRI (or magnetic resonance imaging) which do not use radiation.
  • We continue to re-evaluate our protocols and explore new opportunities for reducing radiation.

For many medical problems in children, the CT scan is invaluable. Often, it’s the only test that can provide the information needed to optimally treat children. There are potential risks and benefits to all medical treatments and procedures.

The CT scan is capable of viewing all the internal organs, which may lead to a diagnosis that was previously only possible with surgery. When we recommend a CT scan, the benefits to a child’s health from the information obtained outweigh the minimal risk associated with the low dose of radiation.

Where kids are concerned, rest assured that their safety and health are our top priority.

For more information about our procedures involving radiology, click here.

To read the Society for Pediatric Radiology’s response to The Lancet article, click here.

12 tips to help keep kids safe this summer

Children’s has one of the busiest pediatric emergency programs in the country, with more than 80,000 visits last year. We love kids here at Children’s, but we’d rather see them safe at home. With Memorial Day weekend fast approaching, we compiled a list of basic tips, with help from our injury prevention experts, to keep kids safe all summer long. Together, we can make safe simple.

For more  safety tips, please visit our Making Safe Simple website.

Sun and heat

1. On hot days, make sure kids drink plenty of water to stay hydrated.

2. Make sure kids are covered. Apply one ounce of sunscreen to the entire body 30 minutes before going outside. Reapply every two hours, or immediately after sweating heavily.

3. When heat and humidity are high, reduce the level of intensity of activities.


4. Kids should wear life jackets at all times when they’re on boats or near bodies of water.

5. Never leave kids alone in or near the pool or open water. In open water, kids should swim with a buddy.


6. Don’t allow kids under the age of 12 to use sparklers without close adult supervision. Don’t allow them to wave a sparkler or run while holding a sparkler.


7. Always watch kids on a playground. Make sure the equipment is age appropriate and surfaces underneath are soft enough to absorb falls.

Lawn mowers

8. Kids under the age of 16 shouldn’t be allowed to use ride-on mowers and those under the age of 12 shouldn’t use walk-behind mowers.

Wheel-sport safety

9. Make it a rule — wear a helmet every time you ride a bike, skateboard, scooter or use in-line skates. Skateboarders and scooter-riders should wear additional protective gear.


10. Every rider should take a hands-on rider safety course.

11. All kids should ride size-appropriate ATVs.

12. All riders should wear full protective gear including a helmet, chest protector, gloves, and shin guards.

Making Halloween safe and fun for your family

Jeri Kayser, a Child Life specialist at Children’s, wrote this post for families.

Halloween is so entrenched in our culture that when you hear the word you are going to get as many diverse opinions about it as there are costumes on the racks at big box stores. There are also countless opportunities to gather information about making this a safe holiday. Additionally, each family is going to develop their own traditions of celebrating, or not celebrating, this holiday. So how can we add to the conversation?

I would argue that there is a developmental perspective that can help guide us as to when children are ready to be part of the festivities and how to best prepare them. Half the fun of having kids in your life is reliving the joys of childhood. Often this eagerness to be a kid again can make us overlook our children’s readiness to participate in Halloween as we buy out all of the fake blood at the store for “the most awesome haunted house ever!” Continue reading

Five tips to avoid sunburns

With all the time kids spend in the sun during the summer, it’s important to know how to protect them from sunburns. At Children’s, we believe in Making Safe Simple — so we’ve put together five tips to help you and your kids avoid sunburn this summer (and what to do if you do happen to get one!).

  • Apply one ounce (two tablespoons) of sunscreen to the entire body 30 minutes before going outside. This gives skin a chance to absorb it. Reapply every two hours, or immediately after sweating heavily.
  • Make your own shade with a wide-brimmed hat or baseball cap. Protect your eyes with UV-blocking sunglasses (the bigger, the better). Just make sure the sunglasses have 90 to 100 percent protection from UVA and UVB rays.
  • Don’t forget to protect areas that are often missed, such as: your chin, nose, ears, scalp, under eyes, shoulders, and on top of your hands. Also apply lip balm with an SPF (Sun Protection Factor) to keep your lips safe.
  • Look for “broad spectrum” sunscreen with an SPF of 15 or higher that includes ingredients that protect you from both UVA and UVB (Ultraviolet A and B) rays. You can also look for the “Skin Cancer Foundation Seal of Recommendation” to help you find the right sunscreen.
  • Don’t be fooled by a cloudy day at the fair. The sun’s harmful UV rays can penetrate through clouds and even a thick fog.
  • If you do get sunburn, aloe vera gel is extremely soothing, nontoxic, and helps heal the skin.

Need more sun-safety tips? Here’s how to protect your kids from dehydration and heat exhaustion.

Five things to know about heat exhaustion

As an incredible heat wave continues in Minnesota, we thought it was a good time to talk about ways to keep kids safe in the heat. In addition to our quick tips for protecting your kids from dehydration, here are tips on avoiding heat exhaustion. We believe in Making Safe Simple, so take a few moments to review these tips!

  1. Children adjust more slowly than adults do to changes in environmental heat. They also produce more heat with activity than adults, and sweat less. Sweating is one of the body’s normal cooling mechanisms. Children often do not think to rest when having fun and may not drink enough fluids when playing or exercising.
  2. Heat exhaustion results from a loss of water and salt in the body due to excessive sweating. It occurs when the body is unable to cool itself properly and, if left untreated, can progress to heat stroke.
  3. Signs of heat exhaustion in children are: profuse sweating, pale skin that’s cool and damp to the touch, rapid and shallow breathing, headache, nausea, normal or below-normal body temperature, vomiting or diarrhea, dizziness, weakness or fainting, and muscle cramps.
  4. If your child is experiencing heat exhaustion, move them to a cool place right away and let them rest. You should remove extra clothing and apply cool cloths (towels with cold water) and fan their skin. Give them cool sports drinks containing salt and sugar such as Gatorade (if they don’t feel nauseous).
  5. Call your doctor or go to the emergency department if their condition hasn’t improved or they are unable to take fluids within an hour.

Staying safe and avoiding dehydration in hot weather

Follow these quick tips to keep your kids safe from dehydration when they're out playing in hot temperatures.

Summertime is definitely here, and what kid can’t wait to get outside and play? But staying safe in the sun, and avoiding dehydration, is important.

We believe in Making Safe Simple. Here are some quick tips to help your kids avoid dehydration:

  • On hot days, make sure you drink plenty of water to stay hydrated. The human body requires at least one liter of water daily.
  • Dehydration means that a child’s body doesn’t have enough fluid. Dehydration can result from not drinking, vomiting, diarrhea, or any combination of these conditions. Sweating or urinating too much rarely causes it.
  • Thirst is not a good early indicator of dehydration. By the time a child feels thirsty, he or she may already be dehydrated. And thirst can be quenched before the necessary body fluids have been replaced.
  • Signs of dehydration in children include the following: sticky or dry mouth, few or no tears when crying, eyes that look sunken into the head, lack of urine or wet diapers for six to eight hours in an infant (or only a very small amount of dark yellow urine), lack of urine for 12 hours in an older child (or only a very small amount of dark yellow urine), dry cool skin, irritability, and fatigue or dizziness in an older child.
  • If you suspect your child is dehydrated, start by replenishing their body with fluids. Plain water is the best option for the first hour or two. They can drink as much as they want. After this, the child might need drinks containing sugar and electrolytes (salts) or regular food. Also, the child should rest in a cool, shaded environment until the lost fluid has been replaced.
  • Call your doctor immediately or take your child to the nearest emergency department if there is no improvement or condition is worsening.